If you've got a lump on top of your shoulder muscle, there's a good chance it's a trapezius knot. In fact, according to a study published in June 2017 by Medicine, these lumps in the trapezius muscle — called myofascial trigger points — are among the most common causes of musculoskeletal shoulder pain. Home remedies can help.
Read more: Spasms of the Trapezius Muscle
Knots in Your Trapezius Muscle
While you might think of the top of your shoulder as your trapezius muscle, this large structure actually spans from the back of your neck to your lower back. Because it attaches to your vertebrae and shoulder blades, it has many functions — shrugging your shoulders, rotating your shoulder blades to allow you arms to move overhead, and pulling your shoulder blades down and together.
Lumps, or trigger points, most often occur in the upper trapezius, or the part that runs on either side of your neck and along the tops of your shoulders. In addition to the lump, these knots are typically painful to the touch and can cause pain to spread to other areas in your shoulder and back.
Common causes of upper trapezius muscle knots include poor posture and psychological factors that increase stressors, such as high pressure at work and low job satisfaction, according to the authors of the June 2017 study in Medicine.
Overuse of the Trap Muscle
Spasms in the upper trap can develop from weakness in other muscles. The rotator cuff and muscles around your shoulder blades help you reach out to the side and overhead — a motion needed for putting away dishes, getting dressed, driving, playing sports and many more daily activities. If these muscles are weak or fatigued, the upper trap will kick in to "help" support your arm.
According to Motion Works Physical Therapy, you might not notice overuse of your trap muscle until it leads to other symptoms — stiffness in your neck while sitting at your desk or pain from your trap that shoots down your arm.
You can reduce your risk of overusing your upper trap by staying conscious of your shoulder position during the day. If your shoulders are hiked up toward your ears during a particular task, take a break and squeeze your shoulder blades down and together before continuing.
Why Treat It?
Even if the muscle knot on top of your shoulder isn't particularly painful, it indicates that your muscle is inflamed. Trigger points in the upper trapezius muscle can negatively affect movement of your shoulder, increasing risk of injury. This is especially true if you perform a lot of overhead activity.
According to a September 2018 study published by the Journal of Human Kinetics, stiffness in the upper trap can decrease shoulder range of motion, increasing the risk of rotator cuff injuries. However, this study also showed that ischemic compression — trigger point release — was effective in treating muscle knots on the top of the shoulder for 12 professional basketball players.
Release Your Trigger Point
While trigger point release is often performed by physical therapists and massage therapists, you can perform this technique on yourself with a massage ball, or substitute with a tennis or lacrosse ball. Try it both standing and while lying on your back.
How to do it: Stand with your back to the wall. Place the ball behind your upper trap directly on the lump, and lean against the wall. Press hard enough to cause tolerable pain.
Hold until the pain subsides by 50 percent, then press harder. Continue to hold this pressure until the pain subsides — typically between 30 seconds and several minutes.
Read more: Exercises for an Upper Back Knot
Stretch It Out
How to do it: Sit up straight and tip your ear toward your shoulder on the unaffected side. Rest your hand on top of your head to gently increase the amount of stretch. Rotate your head slightly and repeat to target different fibers in your trapezius muscle.
Although you might be tempted to work out your trap muscle to reduce lumps and spasms, this technique can actually backfire. According to the National Association of Myofascial Trigger Point Therapists, attempting to strengthen a muscle that has a trigger point puts more strain on the already aggravated muscle, potentially making it worse.
Apply Cold or Heat
Home remedies can help reduce pain caused by muscle spasms and relieve a trapezius knot. Pain that occurs immediately after activity or pain that is sharp is a sign of inflammation, according to Summit Orthopedics. For this type of pain, apply ice to your affected muscle for 10 to 15 minutes to decrease blood flow and inflammation.
If you've had a lump in your trapezius muscle for a few days, and it is achy and annoying, apply heat for 15 to 20 minutes to increase blood flow and help the muscle relax.
Squeeze Your Scapula
Exercise doesn't need to be avoided altogether. Strengthening exercises for your upper back can help improve posture and reduce risk of overuse of your upper trapezius muscle. Perform scapular squeezes without even leaving your desk.
How to do it: Sit up straight on a firm surface. With your arms relaxed by your sides, squeeze your shoulder blades together as if you are trying to hold a pencil between them. Hold for two to three seconds, then relax. Repeat 10 times, working up to three sets in a row.
Be sure your upper trap muscles are relaxed during this exercise. Try it in front of a mirror to help keep your shoulders from shrugging.
When to See a Doctor
While most lumps on the top of the shoulder muscles are likely to be trigger points, there are other medical conditions — such as cancer — that can cause lumps. Cancerous lumps often appear out of nowhere and grow steadily in size. See a doctor for an accurate diagnosis if you have any concerns about a lump in your muscle.
- Muscle: "Predictors of Upper Trapezius Pain With Myofascial Trigger Points in Food Service Workers the STROBE Study"
- BioMed Research International: "Trigger Points: An Anatomical Substratum"
- Journal of Human Kinetics: "Changes in Muscle Stiffness of the Trapezius Muscle After Application of Ischemic Compression into Myofascial Trigger Points in Professional Basketball Players"
- PhysioMed: "Correct Sitting Posture: Office"
- Progressive Chiropractic Wellness Center: "Upper Trapezius Self Stretch"
- Summit Orthopedics: "Treatments You Can Try at Home for Trigger Points"
- National Association of Myofascial Trigger Point Therapists: "Myofascial Trigger Point Therapy - What Is It?"
- Motion Works Physical Therapy: "Common Compensations: Trapezius Pain"